PHARMACOLOGY CH 1-3 STUDY MIDTERM

An agonist is a drug that

(1) has affinity for a receptor, (2) combines with the receptor, and (3) produces an effect. Naturally occurring neurotransmitters are agonists.

A competitive antagonist is a drug that

(1) has affinity for a receptor, (2) combines with the receptor, and (3) produces no effect. - Its presence causes a shift to the right in the dose-response curve . The antagonist competes with the agonist for the receptor, and the outcome depends on the relative affinities and concentrations of each agent. If the concentration of the agonist is increased, the competitive antagonism can be overcome, and vice versa.

Theurapeutic Index (TI)

(TI) is a ratio of the median lethal dose (LD50) to the median effective dose (ED50) and is expressed as follows:

stat

(immediately) now

Metabolism or biotransformation

(the breaking down of a drug) is the body's way of changing a drug so that it can be more easily excreted by the kidneys Metabolism mechanisms o Active to inactive o Inactive to active o Active to active Factors that affect drug metabolism o Impaired liver function o Hepatic portal circulation o Drugs and environmental substances o Inhibitors of cytochrome P450

Idiosyncratic reactions

- Genetically related abnormal drug response. Certain populations, because of their genetic constitution, are more susceptible to certain adverse reactions to specific drugs. Eskimos metabolize certain drugs faster than other populations; therefore a larger dose of those drugs (e.g., isoniazid) would be needed in an Eskimo patient.

Side Effect

-predictable -dose related -acts on non-target organs

List the four factors that are involved when talking about pharmacokinetics of a drug, along with a definition for each.

1. Absorption: Getting the drug into the body. 2. Distribution: How the drug moves around in the body. 3. Elimination: How to body gets rid of chemicals. 4. Metabolism: How the body chemically changes drugs to make them more water soluble or inactive.

1) Drugs act by forming a chemical bond with specific receptor sites, similar to a lock and key. 2)The better the "fit," the better the response. Drugs with complete attachment and response are called ______ 3)Drugs that attach but do not elicit a response are called ______ 4)Drugs that attach and elicit a small response but that also block other responses are called ______ _______

2) agonists. 3) antagonists. 4) partial agonists

How many drug testing phases are there?

4

If one dose of a drug is administered and the drug's half-life in the body is 3 hours, what percentage of the drug would be left after four half-lives? 50% 6.25% 2% Insufficient information to determine

6.25% -The half-life is the time required for a drug level to fall to one half of its concentration. The drug concentration would go to 50% → 25% → 12.5% → 6.25% in four half-lives. The information given is more than sufficient to answer the question. One needs merely to count the number of half-lives and divide the percentage drug in half for every half-life passed since the drug was administered.

Drug A has a therapeutic index (TI) of 2. Drug B has a TI of 10. Which drug has greater potential for toxicity? A) Drug A B) Drug B C) Both drugs have equal potential for toxicity. D) Neither drug has any potential for toxicity.

A

First order kinetics

A constant percent of drug is eliminated from the body per each unit of time. Blood levels are proportional to the dose administered

Drug allergy:

A drug allergy is an immunologic response to a drug resulting in a reaction such as a rash or anaphylaxis. This response accounts for less than 5% of all adverse reactions. Unlike other adverse reactions, allergic reactions are neither predictable nor dose related.

Type II (cytotoxic/cytolytic) reactions are characterized by destruction to what organ, tissue, or cell type?

Circulating blood cells

What would be an advantage for a dentist to call the pharmacy with a prescription for Tylenol #3 rather than hydrocodone for a patient who calls late at night requesting medication for pain following root canal therapy?

A prescription for Tylenol #3 (Schedule III) may be telephoned, whereas hydrocodone (Schedule II) requires a written prescription.

Side effect (adverse reaction):

A side effect is a dose-related reaction that is not part of the desired therapeutic outcome. It occurs when a drug acts on nontarget organs to produce undesirable effects. The terms side effect and adverse reaction are often used interchangeably. The upset stomach produced by ibuprofen is an adverse reaction when ibuprofen is given to manage pain.

Which of the following is true regarding basic principles of drug distribution in the bloodstream? A. All drugs in the blood are either bound to plasma proteins or free. B. Only the drug that is bound to plasma proteins can exert the pharmacologic effect. C. Only the drug that is bound to plasma proteins can pass across cell membranes. D. The free drug is a reservoir for the drug.

A. All drugs in the blood are either bound to plasma proteins or free.

The movement of a drug from one site in the body to other sites is called: A. distribution. B. disruption. C. dispersion. D. active transport.

A. distribution.

The distribution of a drug is determined by blood flow to the organ. presence of certain barriers. plasma protein-binding capacity. solubility of the drug. All of the above

All of the above

Potency:

Amount of the drug required to produce an effect

Which of the following choices is a schedule II controlled substance

Amphetamine

Drugs act on biologic systems to accomplish a desired effect, and they are specific in the organs or tissues they affect. This specificity is the reason for undesirable or adverse drug reactions. A) Both statements are true. B) Both statements are false. C) The first statement is true; the second statement is false. D) The first statement is false; the second statement is true.

B

Few drugs can be considered completely safe for administration to a pregnant woman. However, many of the drugs used in dentistry are considered to be among the most dangerous to the developing fetus. A) Both statements are true. B) Both statements are false. C) The first statement is true; the second statement is false. D) The first statement is false; the second statement is true.

B) Both statements are false.

Patients frequently report that they are allergic to a medication, because allergic or hypersensitivity adverse reactions are the most common type of adverse drug reactions .A) Both statements are true. B) Both statements are false. C) The first statement is true; the second statement is false. D) The first statement is false; the second statement is true.

B) Both statements are false.

In which of the following categories does a drug have only one name? 1. Chemical name 2. Generic name 3. Trade name 4. Both 1 and 2

Both 1 and 2

Schedule III controlled substances may be telephoned to the pharmacist AND may be refilled no more than 5 times in 6 months. Both are true. The first is false, the second is true. The first is true, the second is false. Both are false.

Both are true.

A type IV (delayed-hypersensitivity) reaction is antibody mediated. Examples of a type IV reaction are an Arthus (serum-sickness) reaction. A) Both statements are true. B) Both statements are false. C) The first statement is true; the second statement is false. D) The first statement is false; the second statement is true.

Both statements are false.

Enterohepatic circulation of a drug involves the secretion of a metabolized drug into the intestine. If enterohepatic circulation is blocked, the level of the drug in the serum will fall. Both statements are true. Both statements are false. The first statement is true, the second statement is false. The first statement is false, the second statement is true.

Both statements are true.

Type II (cytotoxic/cytolytic) reactions are characterized by destruction to what organ, tissue, or cell type? A) Bronchioles B) Skin C) Circulating blood cells D) Liver

C) Circulating blood cells

A person who has an abnormal response to a medication based on a genetic component is said to have what type of event? A) Therapeutic effect B) Toxic reaction C) Idiosyncratic reaction D) Allergic reaction E) Teratogenic effect

C) Idiosyncratic reaction

The word stat on a prescription means: A. Before meals B. At bedtime C. Immediately D. Every

C.Immediately

Schedules of Controlled Substances Schedule III - Moderate Examples:

Codeine mixtures (Tylenol #3) -Prescriptions may be telephoned; no more than five prescriptions in 6 months

Type II -

Complement-dependent reactions involving either IgG or IgM antibodies. Cytotoxic/cytolytic § Complement-dependent reactions involving either immunoglobulin G (IgG) or immunoglobulin M (IgM) antibodies

When reviewing the product information on a drug, the dental hygienist notes that it is teratogenic. This drug would be contraindicated for which of the following patients? A) A patient with asthma B) A patient with renal failure C) An adolescent patient D) A pregnant patient

D) A pregnant patient

A nervous patient is given a sedative in the usual therapeutic dose before receiving dental hygiene care. The patient becomes agitated and upset and reports feeling heart palpitations. She begins to cry hysterically when the dental hygienist enters the room. What kind of adverse drug event is happening to this client? A) Toxic reaction B) Drug allergy C) Local effect D) Idiosyncratic reaction

D) Idiosyncratic reaction

- Because death is the end point when one is measuring the lethal dose, LD50 is the dose that causes _____ in 50% of test animals.- The ED50 is the dose required to produce the desired clinical effect in 50% of test animals.

DEATH

Type IV -

Delayed hypersensitivity reactions mediated by sensitized T-lymphocytes and macrophages. Delayed hypersensitivity § Reactions are mediated by sensitized T lymphocytes and macrophages

Schedules of Controlled Substances Schedule IV - Less Examples:

Diazepam (Valium), tramadol (ultram) - Prescriptions may be telephoned; no more than five prescriptions in 6 months

Phase 1 clinical trials involve all of the following except which one? Safe dose range Toxic effects of the drug Metabolism Effectiveness

Effectiveness

What are the two Major Routes of Administration of drugs?

Enteral & Parenteral

Which federal regulatory body is part of the U.S. Department of Health and Human Services (USHHS)?

FDA

Which federal regulatory body regulates the trade practices of drug companies and prohibits false advertising of foods, nonprescription drugs and cosmetics?

FTC

T/F An irreversible antagonist can be surmounted with excess amount of agonist

False An irreversible antagonist binds to a receptor in such a way that it cannot be easily removed from the receptor. Typically, irreversible antagonists contain reactive groups that form strong covalent bonds with the receptor. Therefore, an excess amount of agonist will not be able to displace or surmount an irreversible antagonist from the receptor. Note that an irreversible antagonist is also referred to as a non-competitive antagonist.

What does absorption involve? Absorption is faster with what? How long does absorption typically take for immediate release drugs? How does most absorption take place? What does this mean? (3)

Getting the drug from the Gut into Systemic Circulation. Faster on an empty stomach (especially if the drug is non-fat soluble), slower with food in stomach. Usually range of 20 minutes to an hour for Immediate Release drugs. Most absorption takes place via passive diffusion across a semi-permeable membrane. This means the molecules must be relatively small, neutral charge, and fairly lipid soluble.

Schedules of Controlled Substances Schedule I - Highest Examples:

Heroin, LSD, marijuana, hallucinogens -No accepted medical use; experimental use, only in research

Signs and symptoms of type I anaphylactic shock include all except which of the following? A) Bronchospasm B) Laryngeal edema C) Hypotension D) Hypertension E) Cardiac arrhythmias

Hypertension

Controlled substances in schedule _____ require a written prescription with the provider's signature and do not permit refills. II, III, and IV II and III III and IV II only III only

II only

Name the two body systems that are most affected by an allergic response

Immune System and Respiratory System

Which immunoglobulin (Ig) antibodies are involved in a type I immediate hypersensitivity drug reaction? A) Immunoglobulin G (IgG) B) Immunoglobulin A (IgA) C) Immunoglobulin D (IgD) D) Immunoglobulin E (IgE) E) Immunoglobulin M (IgM)

Immunoglobulin E (IgE)

Where does most absorption actually take place?

In the small intestine.

Describe: Intradermal Route of Drug Administration

Injection into the epidermis

Which route of administration of penicillin is most likely to cause an anaphylactic reaction? A) Sublingual B) Intravenous C) Oral D) Topical

Intravenous

What is the purpose of a "black box warning" on a package insert? -It indicates medications that may be used to manufacture illicit drugs such as methamphetamine. -It is used to reconstruct the events leading to a fatality resulting from a medication error .-It means that the effects of the drug have not yet been determined. -It is used to draw attention to potentially fatal, life threatening or disabling adverse effects for different medications.

It is used to draw attention to potentially fatal, life threatening or disabling adverse effects for different medications.

What is the most important site for the metabolism of drugs?

Liver

Efficacy:

Maximal effect of a drug, regardless of dose

Type I-IV sensitivity reactions Type I -

Mediated by IgE antibodies. Immediate hypersensitivity; anaphylaxis § Anaphylactic shock § Rhinitis § Asthma § Urticaria § Dermatitis § Hypotension § Bronchospasm § Laryngeal edema § Cardiac arrhythmias

Type III -

Mediated by IgG antibodies. Immune Complex, Arthus, Serum Sickness § Mediated by IgG antibodies § Manifested as: · Serum sickness · Urticarial skin eruptions · Arthralgia · Arthritis · Lymphadenopathy · Fever

What is the trade(brand) name of ibuprofen?

Motrin, Advil

Pharmacokinetics:

Movement of drugs through the body

For each drug, there is only _____ generic name (e.g., ibuprofen), selected by the United States Adopted Name Council, and the name is not capitalized.

ONE

Schedules of Controlled Substances Schedule II - High Examples:

Oxycodone, morphine, amphetamine, secobarbital, hydrocodone (alone or in combination with ibuprofen or acetaminophen) - Written prescription with provider's signature only; no refills

What is pharmacokinetics? What does it include? (4)These factors effect what?

Pharmacokinetics is the study of how the body handles a drug over a period of time. This includes absorption, distribution, biotransformation, and excretionThese factors affect a patient's response to drug therapy.

Clinical studies of drugs first involve human volunteers during which phase of drug testing? Phase 1 Phase 2 Phase 3 Phase 4

Phase 1

what phase of clinic trials involves safe dose range, toxic effects of the drugs, and metabolism?

Phase 1

Phase 1

Phase 1: Small and then increasing doses are administered to a limited number of healthy human volunteers, primarily to determine safety. This phase determines the biologic effects, metabolism, safe dose range in humans, and toxic effects of the drug.

Phase 2

Phase 2: Larger groups of humans are given the drug and any adverse reactions are reported to the FDA. The main purpose of phase 2 is to test effectiveness.

Phase 3

Phase 3: More clinical evaluation takes place involving a large number of patients who have the condition for which the drug is indicated. During this phase, both safety and efficacy must be demonstrated. Dosage is also determined during this phase.

Phase 4

Phase 4: This phase involves postmarketing surveillance. The toxicity of the drug that occurs in patients taking the drug after it is released is recorded. Several drugs in recent years have been removed from the market only after phase 4 has shown serious toxicity.

during which phase of clinical trials of a new drug is safety, efficacy, and dosage determined?

Phase III

Which best describes an adverse drug reaction? A) Immunologic response to a drug resulting in rash or anaphylaxis B) Genetically related abnormal unpredictable drug response C) Extension of the pharmacologic effect (i.e., overdose) D) Predictable undesirable effect occurring at usual therapeutic doses E) Clinically desirable or intended effect of the drug

Predictable undesirable effect occurring at usual therapeutic doses

Schedules of Controlled Substances Schedule V - Least Examples:

Some codeine-containing cough syrups -Can be bought over-the-counter in some states

Zero order kinetics

Some drugs are eliminated at a constant rate, despite the amount of drugs present (aspirin)

Pharmacodynamics:

The body's biological response to drugs

When a drug combines with a receptor, it alters the function of the organism. It may produce enhancement or inhibition of the function. Drugs that combine with the receptor may be classified as either _____ or ______

agonists or antagonists

Penicillins, ester local anesthetics, and aspirin are drugs used in dentistry that have produced fatal anaphylaxis. Anaphylaxis is more common when penicillin is given by the oral route rather than by injection. A) Both statements are true. B) Both statements are false. C) The first statement is true; the second statement is false. D) The first statement is false; the second statement is true.

The first statement is true; the second statement is false.

Describe the dose-response curve using the terms ED50 (effective dose) and LD50 (lethal dose).

The potency of a drug can be expressed in terms of the median effective dose (ED50). The ED50 is the dose of a drug required to produce a specific effect in 50% of the subjects or the dose that produces half of the maximum effect. The median lethal dose (LD50) is the dose when one half of the subjects die.

Half life

The time required for the total amount of drug in the body to decrease by 50%. Most drugs are essentially eliminated after approximately five half-lives

Phase I clinical trials involve all of the following except one. Which of the following choices is the exception

Therapeutic activity

Topical Route of Drug Administration

Topical Route of Drug Administration § Advantages · Systemic side effects are rare § Disadvantages · Increased risk of systemic side effects if surfaces are large and/or abraded, inflamed, or sloughing · Intraorally sprayed anesthetics may be absorbed into blood stream • Drug applied to a body surface (skin, mucosa) • Most effective in non-keratinized areas • Used when local effect is desired

A prodrug is an inactive drug compound that becomes transformed into an active drug compound. True False

True -This statement represents an example of drug metabolism (converting a drug from inactive to active).

What is the trade(brand) name of acetaminophen ?

Tylenol

An antagonist counteracts the action of the agonist. The following are three different types of antagonists:

competitive antagonist Noncompetitive antagonists physiologic antagonist

In a _____________ reaction, inflammation is produced by sensitized T lymphocytes and macrophages coming in contact with an antigen, producing lymphokines and cytokines.

Type IV

A drug's generic name is selected by

U.S. Adopted Name Council

Prescription drugs are controlled by the United States Food and Drug Administration (FDA). Centers for Disease Control (CDC). drug manufacturers. local government.

United States Food and Drug Administration (FDA).

When a drug has affinity for a receptor and produces no effect, it is called a(n) agonist. competitive antagonist. competitive agonist. physiologic agonist.

competitive antagonist.

If a drug displays zero-order elimination kinetics elimination increases as the dose of the drug is increased. a constant amount is eliminated per unit time. the drug is not eliminated and is retained in the body. the elimination of the drug cannot be predicted mathematically.

a constant amount is eliminated per unit time. -With zero-order kinetics, the metabolism or excretion mechanisms for a drug in the body are saturated, meaning that they are at their maximal level. If more drug is given, then the body cannot keep up, and the drug levels will increase. The body cannot adjust to more drug, and elimination of a drug will remain the same as the dose of the drug is increased. If the drug is eliminated but a longer time is required, then it would for a first-order elimination. The elimination of the drug can be mathematically predicted.

Noncompetitive antagonists bind to

a receptor site that is different from the binding site for the agonist. Its presence reduces the maximal response of the agonist.

Which of the following is not a subject of pharmacokinetics? a. Physiologic action of drugs b. Metabolism of drugs c. Elimination of drugs d. Absorption of drugs

a. Physiologic action of drugs

With zero-order kinetics, the a. same amount of drug is metabolized and eliminated from the body per unit of time regardless of dose. b. same percentage of drug is metabolized and eliminated from the body per unit of time. c. drug is irreversibly bound to receptor sites.d. drug is not bound to receptor sites.

a. same amount of drug is metabolized and eliminated from the body per unit of time regardless of dose.

Pharmacokinetics is the study of how a drug enters the body, circulates within the body, is changed by the body, and leaves the body. Factors that influence the movement of a drug are divided into four major steps:

absorption, distribution, metabolism, and excretion (ADME).

The Drug Enforcement Administration (DEA) of the Department of Justice administers the Controlled Substances Act of 1970. This federal agency regulates the manufacture and distribution of substances that have a potential for

abuse, including opioids (narcotics), stimulants, and sedatives.

Which of the following is an undesirable effect produced by a drug that has a predictable response and is dose related?

adverse effect

Which of the following terms is defined as "an effect that is noxious and unintended, and that occurs at doses used in man for prophylaxis, diagnosis, or therapy"?

adverse reaction

p

after

ud

as directed

prn

as required, if needed

hs

at bedtime

One dose of a drug is administered that has a half-life of 8 hours. Assuming first-order kinetics, how much time is needed for this drug to be over 96% eliminated from the body? a. 8 hours b. 40 hours c. 60 hours d. 120 hours

b. 40 hours

Which of the following choices is the process by which a substance is transported against a concentration gradient? a. Passive transfer b. Active transport c. Facilitated diffusion d. Filtration

b. Active transport

Which drug is eliminated with zero-order kinetics? a. Probenecid b. Aspirin c. Allopurinol d. Penicillin e. Naproxyn sodium

b. Aspirin

If a drug displays zero-order elimination kinetics a. elimination increases as the dose of the drug is increased. b. a constant amount is eliminated per unit time. c. the drug is not eliminated and is retained in the body. d. the elimination of the drug cannot be predicted mathematically.

b. a constant amount is eliminated per unit time.

a

before

ac

before meals

Two drug formulations that produce similar concentrations in the blood and tissues after administration are termed _______________ equivalent. biologically chemically therapeutically

biologically

Drugs can be judged "similar" in several ways. When two formulations of a drug meet the chemical and physical standards established by the regulatory agencies, they are termed chemically equivalent. If the two formulations produce similar concentrations of the drug in the blood and tissues, they are termed _______ equivalent. If they prove to have equal therapeutic effects in a clinical trial, they are termed _______ equivalent. A preparation can be chemically equivalent yet not biologically or therapeutically equivalent. These products are said to differ in their bioavailability. Before generic drugs are marketed, they must be shown to be biologically equivalent, which would make them therapeutically equivalent.

biologically , therapeutically

Which of the following terms is used to indicate that medical studies have shown that the drug causes a significant risk of serious or even life-threatening adverse effects? package insert black box warning DEA number indications

black box warning

used to draw attention to potentially fatal, life threatening, or disabling adverse effects for different medications

black box warning

PO

by mouth

Parenteral drug administration

bypasses the GI tract • Intravenous (IV) • Intramuscular (IM) • Subcutaneous (SQ) • Intradermal • Inhalation • Topical

cap

capsule

Chemical name, which is determined by its

chemical structure.

How many half-lives of repeated dosing does it take to reach a steady state in the body? a. One b. Two or three c. Four or five d. Six or seven e. Eight or nine

d. Six or seven

d

day

disp

dispense

gtt

drop

The half-life of a drug is most related to its a. onset. b. duration. c. safety. d. time to peak concentration.

duration

An antagonist has a) Negative intrinsic activity b) Intrinsic activity similar to inverse agonists c) Positive intrinsic activity d) Intrinsic activity fluctuates according to the receptor target e) Zero intrinsic activity

e) Zero intrinsic activity Antagonists by definition block the effect of an agonist on a receptor. Therefore, antagonists prevent a receptor from becoming activated and have zero intrinsic activity. In other words, antagonists do not activate a receptor.

Which of the following terms describes the drug dose that produces 50% of the maximum possible response? effective dose (ED50) lethal dose maximum response half-life (t1⁄2)

effective dose (ED50)

q

every

Passive diffusion of drugs across cell membranes/tissue barriers requires energy true or false

false

Passive diffusion of drugs across cell membranes/tissue barriers requires energy . True False

false

The Federal Trade Commission (FTC) regulates the trade practices of drug companies and prohibits the

false advertising of foods, nonprescription (OTC) drugs, and cosmetics.

qid

four times a day

Aspirin can cause adverse reactions such as

gastric upset or pain. - Side effects such as gastrointestinal upset, although bothersome, are not reasons to avoid prescribing a medication.

Acetaminophen is a: generic name chemical name trade name brand name

generic name

Which type of drug name usually begins with a lowercase letter? Brand name Code name Generic name Trade name

generic name

a drug may have only one ____________ name, but it may have several _____________ names.

generic, trade(brand)

gr

grain

gm

gram

A physiologic antagonist

has affinity for a different receptor site than the agonist. Its presence decreases the maximal response of the agonist by producing an opposite effect via different receptors.

h

hour

A maintenance dose of drug is given to

keep blood concentration in the therapeutic range.

What is the most important organ for excretion (renal excretion)?

kidney Glomerular filtration (only thing need to know regarding Renal)

The _____ is the most common site for biotransformation. kidney blood plasma liver small intestine

liver

Which organ is involved in the first-pass effect after oral administration of a drug? a. Kidney b. Lungs c. Liver d. Spleen

liver

The FDA, which is part of the Department of Health and Human Services (DHHS), grants approval so that drugs can be

marketed in the United States.it must be determined to be both safe and effective.

Advantages of oral administration of a drug include all the following except large surface area for drug absorption. many different dose forms that may be administered orally. more predictable response than intravenous administration. the simplest way to introduce a drug into the body.

more predictable response than intravenous administration.

Absorption: Active Transport

moves substance against concentrated gradient- requires carrier protein and an input of energy glucose and galactose

Drug allergy:

not predictable or dose related

Explain how half-life relates to clinical pharmacokinetics. First-Order Kinetics

o Half-life of drug is amount of time that passes for its concentration to fall to half (50%) of its original blood level o Takes approximately 4 to 5 half-lives for a drug to be considered eliminated from the body o A few drugs exhibit zero-order kinetics § Rate of metabolism remains constant over time

Absorption: Passive transfer

o Simple diffusion: Lipid-soluble substances move across lipoprotein membrane by this passive transfer process § this type of transfer is directly proportional to the concentration gradient of drug across membrane and degree of lipid solubility

Teratogenic (birth) effect

o terato- = monster o -genic = producing o Teratogens are agents that cause congenital malformations and developmental abnormalities if introduced during gestation o Drugs safe to use during pregnancy § Penicillin § Erythromycin § Acetaminophen § Local anesthetic lidocaine o Drugs contraindicated during pregnancy § Tetracycline § Nonsteroidal antiinflammatory agents § Benzodiazepines § Metronidazole

ss

one half

Which of the following terms describes the actions of a tablet on the body after ingestion and absorption? pharmacology pharmacokinetics pharmacodynamics toxicology

pharmacodynamics

Enteral drug administration

placed directly into the GI tract • Oral route • Rectal route

A noncompetitive antagonist - binds to the same receptor site as the binding site for the agonist. - causes a shift to the right in the dose-response curve. - enhances the maximal response of the agonist. - reduces the maximal response of the agonist by binding to a different receptor site than the agonist.

reduces the maximal response of the agonist by binding to a different receptor site than the agonist.

Elimination

removal of a drug from the body

on a prescription, the directions to the patient are preceded by what

sig

tab

tablet

tid

three times a day

A black box warning is about a drug that the FDA has required a manufacturer to prominently display in a box in the PI. true or false

true

The greater the TI, the safer the drug. Drugs with a lower TI (closer to zero) require careful monitoring to avoid toxic reactions true or false

true

Weak acids such as aspirin are more readily absorbed from the stomach than weak bases. True False

true

bid

twice a day

Contraindications for Topical Route of Drug Administration

ulcerated, burned or abraded surfaces

Which of the following items is associated with an adverse drug reaction?

unintended response to the drug

c

with

s

without

sig

write (label)

Describe: Inhalation Route of Drug Administration

§ Examples: Inhalers used to treat asthma, general anesthetics, nitrous oxide/oxygen § Advantages · Rapid onset of action · Lack of need for needles § Disadvantage · Popular route for abuse of drugs

Potency

—related to the amount of drug needed to produce an effect.Less potent drugs require higher doses to produce therapeutic effects, whereas more potent drugs can reach toxic levels at lower doses.(The potency of a drug is a function of the amount of drug required to produce an effect.)

Efficacy

—related to the maximal effect of a drug regardless of doseEfficacy is the maximum intensity of effect or response that can be produced by a drug .- Administering more drug will not increase the efficacy of the drug but can often raise the probability of an adverse reaction.

Disadvantages of Rectal Route of Administration

• Drugs are poorly and irregularly absorbed • Poor patient acceptance

Disadvantages: Intravenous (IV) Route of Drug Administration

• Phlebitis • Drug irretrievability - drug is immediately absorbed and cannot be easily treated with an antidote • Allergy

Advantages: Intravenous (IV) Route of Drug Administration

• Produces MOST RAPID drug response • More predictable blood levels • BEST for emergency situations • Absorption phase bypassed

Describe: Intramuscular (IM) Route of Drug Administration

• Provides a sustained effect • Absorption due to high blood flow in skeletal muscle • Massaging muscle will increase the drug's absorption • Deltoid or gluteal muscles are common injection sites

Describe:Oral Route of Drug Administration

• Safest • Least expensive • Most convenient • Large area for absorption (small intestine)- less predictable blood levels and can be inactivated by acid, enzymes and 1st pass effect

Advantages of Rectal Route of Administration

• Used if patient is vomiting or unconscious• Produces local or systemic effect

Describe: Subcutaneous (SQ) Route of Drug Administration

• Used to administer protein products • Local anesthesia in dentistry is delivered subcutaneously • Insulin is administered subcutaneously • Side effects of subcutaneous administration may include sterile abscess or hematoma